Event Information:

If using a city park or Uptown Artway, check the box to confirm that you have reserved the location with Marion Parks & Recreation

Beginning Time of Event/Activity:

Ending Time of Event/Activity:

Set Up Date:

Set up Time:

Tear Down Date:

Tear Down Time:

Number of Participants Expected

Number of Spectators Expected:

Number of Volunteers Expected:

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Request Information: (check all applicable options)

If you are requesting the closing of a city street, a lane must be maintained for emergency vehicles at all times. Driveway access for adjoining property owners must be maintained at all times.

Request Information: (check all applicable options)
If you are requesting the closing of a city street, a lane must be maintained for emergency vehicles at all times. Driveway access for adjoining property owners must be maintained at all times.

Temporarily close a street for a block party (specify street:)If other, type text here.

Temporarily or partially close a street or sidewalk for BUILDING CONSTRUCTION. If your construction activity includes a street or sidewalk closure, you must hire an insured traffic control contractor to provide a traffic and/or pedestrian control plan, barricades and traffic control signage. The City of Marion does not provide traffic control signs. If you are closing a street for more than 24 hours, the applicant must notify affected residents (specify street or sidewalk). If other, type text here.

Traffic Control Contractor CompanyIf other, type text here.

Contractor Name:If other, type text here.

Contractor Phone Number:If other, type text here.

Oversized Load: Contact the Engineering Department at 319-743-6340 with any questions.

Load SizeIf other, type text here.

Has the IA DOT been informed?If other, type text here.

Please Attach Route Map:

Temporarily install structure in the street right-of-way. The City reserves the right to remove any structure within 48 hours with notice at the applicants' expense if the structure is not removed after the end time of the event/activity given on this application. (specify location and type of structure)If other, type text here.

Items needed from the City of Marion:

Emergency "No Parking" Signs: Can be obtained at the Public Services Department, 195 35th Street, 319-377-6367. Not available for traffic control or construction.

Other (please specify:)If other, type text here.

5

Sound Systems:

Please note, you must comply with the City of Marion Noise Ordinance. Upon request, City Council may authorize time extensions or sound levels up to 75 decibels. Please indicate if the following will be used:

Sound Systems:
Please note, you must comply with the City of Marion Noise Ordinance. Upon request, City Council may authorize time extensions or sound levels up to 75 decibels. Please indicate if the following will be used:

Amplified sound/speaker system

Recorded music

Live music

Public address system

6

Trash:

Applicant is responsible for the clean-up of the event area immediately following the event, including trash removal from the site.

Trash:
Applicant is responsible for the clean-up of the event area immediately following the event, including trash removal from the site.

Will additional restrooms be brought to the site?

If yes, how many?

Contact Person:

Organization/Contractor

Address

Daytime Phone:ext.

Cell Phone:ext.

7

Portable Restrooms:

Please name the individual, organization or contractor responsible for delivery/pick up of portable restrooms.

Portable Restrooms:
Please name the individual, organization or contractor responsible for delivery/pick up of portable restrooms.

Contact person:

Organization/Contractor

Address:

Daytime phone:

Cell phone:

8

Security:

Security personnel may be required by the Chief of Police at the applicant's expense. If required, what type of security will be provided?

Security:
Security personnel may be required by the Chief of Police at the applicant's expense. If required, what type of security will be provided?

Off Duty Marion Police Officers

Number of Officers requested:If other, type text here.

Number of Medical Personnel requested:If other, type text here.

Private Firm

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If hiring a private security firm, please provide the following:

If hiring a private security firm, please provide the following:

Name of Security Firm:

Contact person:

Address:

Phone:

Agreement:

In consideration of the City of Marion, Iowa, granting permission for the activity described above, the undersigned indemnifies and holds harmless the City of Marion, Iowa, its employees, representatives and agents against all claims, liabilities, losses or damage for personal injury and/or property damage or any other damage whatsoever on account of the activity described above and/or deviation from normal City regulations in the area. The undersigned further agrees to indemnify and hold harmless the City of Marion, Iowa, its employees, representatives and agents against any loss, injury, death or damage to person or property and against all claims, demands, fines, suits, actions, proceedings, orders, decrees and judgments of any kind or nature and from and against any and all costs and expenses including reasonable attorney fees which at any time may be suffered or sustained by the undersigned or by any person who may, at any time, be using or occupying or visiting the premises of the undersigned or the above-referenced public property or be in, on or about the same, when such loss, injury, death or damage shall be caused by or in any way result from or rising out of any act, omission or negligence of any of the undersigned or any occupant, visitor, or user of any portion of the premises or shall result from or be caused by any other matters or things whether the same kind, as, or of a different kind that the matters or things above set forth. The undersigned hereby waives all claims against the city for damages to the building or improvements that are now adjacent to said public property or hereafter built or placed on the premises adjacent to said property or in, on or about the premises and for injuries to persons or property in or about the premises, from any cause arising at any time during the activity described above. The undersigned further agrees to comply with all the rules, regulations, terms and conditions established by the City of Marion, Iowa.

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Applicant Agreement

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Applicant Agreement

BY TYPING MY NAME BELOW, I CONFIRM THAT I HAVE READ AND FULLY UNDERSTAND THIS DOCUMENT, INCLUDING THE FACT IT IS RELEASING AND WAIVING CERTAIN POTENTIAL RIGHTS, AND VOLUNTARILY AND FREELY AGREE TO THE TERMS AND CONDITIONS AS SET FORTH HEREIN.